Clinical complications of Sickle Cell Disease (SCD) can affect individuals at nearly any age and lead to deleterious effects on health-related quality of life (HRQoL) and high health care costs. The prevalence of depressive symptoms in SCD patients is high when compared to the general African American population. In accordance with the AHRQ's mission to support health services research that will improve the quality of health care and promote evidence-based decision making, the study will provide us with the appropriate tools to identify risk factors for clinical depression and will further improve our ability to target physical and mental factors that may have a detrimental effect on both medical and QoL outcomes in SCD. The Study Objectives are to 1) Determine the prevalence of depression in SCD patients and its correlation to disease severity, anemia and decline of cognitive function, 2) Determine the relationship between depression and health care utilization by SCD patients and the cost incurred, 3) Identify the association of depression with quality of life measures in SCD patients. Methods: Patient clinical and medical histories will be obtained using a standardized data collection form. The project will take place over a period of two years. Patients will be enrolled over one year. All patients enrolled will be re-assessed after six months from the date of first interview. The prevalence of depression will be assessed using the Beck Depression Inventory. Disease severity will be determined using end-organ severity score calculated at the time of enrollment as well as frequency of hospital admissions during the previous year. The "CNS Vital Signs Test" will be used to assess patients'cognitive functions. Patient diaries and prescriptions will be used to determine the use of narcotics. Health care utilization will be determined prospectively from the time of enrollment using medical records and patient diaries. QoL measures will be assessed using the SF12 short form. Overall, this study will examine the complex relationship between SCD disease-related chronic pain, opioid use, depression, quality of life, and health care utilization. Furthermore, this study will help optimize utilization of medical care by identifying factors that lead to greater health care utilization as well as poorer outcomes.